Elizabeth Cartwright

Patients without borders: understanding medical travel.

The rapidly growing medical travel industry has implications for the health sytems of both sending and receiving countries. This article outlines the political economy of the industry and the potential opportunities and disadvantages it poses for access, equity, and the right to health. Although the trade carries economic benefits for countries receiving foreign medical patients, it comes at a cost to the provision of public health, through distortions in the health workforce and the development of two-tiered health systems. Inequalities and failures in the health systems of sending countries largely drive the need to travel for care.

Immigrant Dreams: Legal Pathologies and Structural Vulnerabilities Along the Immigration Continuum

This article contextualizes the results from a mixed methods study of the living and working conditions of Latino agricultural workers in northern Montana. The results of both the health needs assessment survey and the retrospective life-histories of these migrant farmworkers paint a picture of a population that is barely surviving in the United States, even after decades of living and working here. This article interrogates Singers notions of “harmful social conditions and injurious social connections” that characterize syndemics of ill health through a detailed description of how different immigration statuses create particular local biologies embedded in the structural violence of powerlessness and lost life potentials. For Mexican immigrants to the United States, the immigration system itself is a powerful pathogen.

Diagnosing the Structure: Immigrant Vulnerabilities in Global Perspective

May 31, 2011, Australia: the morning news. The body of an asylum seeker, Meqdad Hussain, who died while in immigration detention in the isolated far north of the country, has been returned to Afghanistan, two-and-a-half months after his death. His surviving family live in Quetta in Pakistan, but Pakistan authorities refused to accept the body. So Meqdad’s younger brother, aged 10 and now the household head, has traveled 10 hours by road from Quetta to Kabul to claim the coffin. Others seeking asylum—from Burma, Afghanistan, Iraq, Bhutan, and elsewhere in Asia and Africa—are detained in Australia if they are lucky. Far more are offshore with the threat of relocation as detainees to a third country, with no clear way forward. And this is one small bite into a crisis that affects millions of people worldwide. Two thirds are internally displaced and vulnerable within their own borders; one third are refugees, asylum seekers, illegal immigrants, and visa ‘‘overstayers.’’ In the previous issue ofMedical Anthropology, the focus was on the structural vulnerability experienced by Latino immigrants in the United States. Their plight is shocking, yet, as Quesada, Hart, and Bourgois note, their

Women's Health: New Frontiers in Advocacy & Social Justice Research–Introduction

Public health research and practice today faces many new challenges. Major threats to human security have occurred, including: natural disasters from tsunamis, hurricanes and earthquakes; violent deaths from civil unrest and population displacement; terrorism; new, emerging and continuing pandemics ranging from HIV/AIDS to Avian influenza; and persistent and chronic disease from worsening poverty and social inequalities. These challenges create and sustain vulnerabilities that require new and innovative interventions, which take account of the importance of the power differentials between the vulnerable and marginalized populations most affected by these threats. The challenges also require the expertise and efforts of researchers, practitioners and policy-makers whose role it is to explore and address these issues. Recent events, such as the catastrophic hurricanes along the Gulf coast of the United States brought into stark reality the non-randomness of the

Anthropological Perspectives on Participation in CBPR Insights From the Water Project, Maras, Peru

In this article, we anthropologically explore one part of the process of Community-Based Participatory Research (CBPR): participation. Participation in CBPR is usually conceptualized as whether, and the degree to which, community members are involved in the research process. Our focus regarding participation is less on quantity and more on quality of the interaction between community members and researchers; within this context, we elaborate the concept of “bridging” as it is understood in CBPR. Using data from our ongoing “Water Project” in the Peruvian Andes, we explore how interaction, as a participative act of the research interview, creates the space for participating and imagining. Out of this interaction come data that are elaborated, contextualized, and, ultimately, from a CBPR perspective, made useful for meaningful engagement and community action.

Dissecting Images: Multimodal Medical Anthropology

When Foucault spiraled into the historical depths of the rise of the modern clinic and the doubleedged sword of biopower, he foregrounded the primacy of the medical gaze (Foucault 1973). With each successive advance in the technologies of visual and auditory perception came dominance over and subjugation of the body and its diseases, the biopower complex began. First, advancing technologies of auscultation then visualization permitted an increased penetration into the body; feeling and hearing from without, then seeing organs, then cells, and then the tiniest of microprocesses that power the cells. Along with the increased capacity to perceive came the capacity to name, to classify, to manipulate, and ultimately to control and to cure. That process of striving to visualize, understand, and control continues. Taking inspiration from this trajectory of Foucault’s conception of the gaze, the authors in this special issue dissect images, their content, the processes that created them, and their ability to display, distort, and preserve minute slices of our lived moments. Images, both moving and still, used in these articles bring with them insights into the multimodal environment where we live and work (Collins, Durrington, and Gill 2017). They show how we interact with other people and objects in our environment, they include information on the places and spaces where research took place, and they preserve metadata that demonstrate the timing of events and of the interactions of the researchers. We emphasize the trust, timing, and tempo of the processes that surround making meaning of the images both by participants and researchers. By engaging these images as data, as actors themselves, we can tweak our theoretical notions about how they play an expanded role in the work of medical anthropology. Central to our theme of considering images (and more broadly multimodality) for use in medical anthropology is our recognition that images (and other modes) are representations of the world filtered by the positionalities of the makers themselves, influenced by unique experiences that brought them to that point in time. Their conscious effort to use a camera to capture something of interest reflects their intent, or motivation, to do more than simply document and describe for an audience. Images become an extension of a way of thinking, visually connecting maker with participant along lines of thought. In this special issue, we share six examples of how images inform and enhance our approaches to the body and its well-being, encouraging logophiles to consider making images in a multimodal sense for more than illustration in film or print production. Rather, we encourage people to include the dynamic process of the production of knowledge, in which researcher, participant, and audience are each present and contribute to the work.

Peaches for Lunch: Creating and Using Visual Variables

ABSTRACT In this article, I describe the process of systematically including nonverbal data in medical anthropology research. I demonstrate the process of visualizing and coding videotaped moments of life and show how we can analyze what is being done along with what is being said. I ground my discussion in toddler language socialization and then expand my observations to the realm of language pathologies. Aphasia from strokes, speech difficulties in neurologically based illnesses like Lou Gehrig’s disease, and the variety of communication challenges that face those on the autism spectrum can all be studied in interesting ways by including precise descriptions of nonverbal actions. I discuss the process of recording and coding the data with the software Observer XT 11.5 by Noldus. This method of collecting and analyzing video data can be used for many anthropological questions, in addition to those concerned with communication. Video abstract Read the transcript Watch the video on Vimeo